For all the commotion surrounding the terms of the UK’s departure from the EU, you would be forgiven for forgetting the government’s ongoing attempts to sign new trade agreements elsewhere. However, it would be a mistake to turn our attention to these deals only after the dust has settled on the terms of Brexit. The government is already laying the groundwork for the UK’s future trade partnerships. Trade negotiations will matter for the UK’s diplomatic relations, the environment, and the economic prosperity of trade-dependent sectors. As my research shows, they can also impact on our wellbeing in other ways, including our health.

One of the most high-profile new deals currently being sought is a US-UK agreement. US trade deals can have wide-ranging effects on health, creating both opportunities and challenges. When Donald Trump’s administration published its negotiating objectives for a US-UK deal, critics warned that a US demand to remove costly sanitary standards in the UK’s farm industry would lead to an influx of chlorine-washed chicken and hormone-pumped beef. Others emphasised that a deal could spell the end of the NHS and push up drug costs by granting access to US pharmaceutical monopolies.

Less attention has been paid to how a US-UK deal might impact on one of the most pressing public health issues of our time: obesity.

Canada’s experiences of trade with the US reveal important lessons about how the US exports high-calorie, sugar-laden diets to its trade partners whilst simultaneously pressuring governments to abandon effective obesity policy. What makes these lessons all the more insightful is that Canada’s trade deals have regularly been used as a model for other treaties – including a US-UK deal.

The Canadian food supply increased by up to 170 kcal per person per day after the 1989 trade deal with the US deal was implemented.

Canada implemented a series of landmark trade deals with the US from 1989 onwards. As CBC reporter Kelly Crowe quipped, what happened next is a 'reminder to read the fine print'. First, in 1989, Canada implemented the Canada-US Free Trade Agreement (CUSFTA). The trade deal was unexpectedly implemented following a highly contentious election, creating a kind of ‘natural policy experiment’ used in social science research to evaluate large scale interventions when randomized trials are not feasible.

Our study in the American Journal of Preventive Medicine found that the number of calories in the Canadian food supply increased by up to 170 kcal per person per day after the 1989 deal was implemented.

When consumed, this amount can lead to an average weight gain of between 1.8 and 12.2 kilograms (depending on sex and physical activity levels). Indeed, obesity rates doubled in the period after CUSFTA was implemented, suggesting that CUSFTA played a partial role in expanding Canadian’s waistlines by increasing calorie intake. This followed a surge in imports of American foods to Canada and US investment in the Canadian processed food industry following the 1989 deal.

Next, in 1994, the better-known North American Free Trade Agreement (NAFTA) came into force, creating yet another natural policy experiment. A major focus of NAFTA was to bring Mexico into the fold, meaning that many Canada-US arrangements were unchanged. But the agreement contained a series of subtle changes to how Canada taxed imports of high-fructose corn syrup (HFCS), a type of sugar commonly found in soft drinks, ice cream and sugary cereals in the US. Whilst these taxes were excluded from the earlier 1989 deal due to disagreements over how to change sugar tariffs, from 1994 onwards Canada removed its 5% import tariff on HFCS. The result? Our study found that the amount of high-fructose corn syrup in the Canadian food supply tripled following NAFTA.

Finally, in 2017, the US, Canada and Mexico began to re-negotiate NAFTA after months of repeated threats by President Donald Trump to withdraw from the deal. Under pressure from the food industry, the Trump administration attempted to use the trade talks to limit the ability of the pact’s members to place health warning labels on the front of junk food packages. Canada’s chief NAFTA negotiator, Steve Verheul, ultimately stated that Canada would not agree to any such labelling ban. In spite of this, our analysis of trade policy debates at the World Trade Organization found that the US continues to pressure other governments into abandoning similar health warning labels.

Canada’s record raises serious questions about how a US-UK deal could increase consumption of sugary, calorie dense diets.

Kenneth Rogoff, former Chief Economist at the IMF, argues that Canada’s record raises serious questions about how a US-UK deal could increase consumption of sugary, calorie dense diets and prevent the UK government from regulating calorie dense foods and soft drinks. At the same time, the fact that Canada rejected US proposals to scrap food warning labels underscores how the trade secretary’s approach to US trade negotiations can prevent these possible harms.

Liam Fox therefore oversees a policy area that reaches far beyond the trade arena. He is in charge of negotiating a suite of new deals which have far-reaching implications for the future of the UK’s health. Furthermore, his approach to trade negotiations and appreciation of these impacts will determine whether the UK harnesses trade benefits whilst minimising health harms. The Faculty of Public Health’s guidelines for negotiating healthy agreements, published in April, provide suggestions about how to address this. Among their recommendations are ensuring that new trade deals give health a ‘seat at the table’ in trade negotiations and embedding the UK government’s existing commitments to ‘do no harm’ to the public’s health into future deals. As Canada’s example illustrates, the future of the UK’s commitment to curbing obesity may very well depend on it.

About the author

Pepita Barlow is a Research Associate at the Bennett Institute for Public Policy, Cambridge. Her primary research interest is in the political economy of health and well-being: how politics and economics ‘get under the skin’ to impact peoples’ opportunities for living healthy lives.

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